| NPI | 1730414152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101254281) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194401) |
| Enumeration Date | 2009-10-03 |
| Last Update Date | 2021-03-31 |